Better Living Through Algorithms: Health Care Contest Looks to Data Miners for Solutions

A colleague describes Dr. Randy Axelrod as “80% doctor, 20% quant.” In high school he took college-level math courses. During his residency, he used his free time studying database programming. As a medical doctor he has worked ER, but he has also run models analyzing patient risk prediction.

Today Axelrod is competing in a contest that one could say was custom made for him. In April Heritage Provider Network, a California physicians group that contracts with a over 32,000 physicians and 100 hospitals, launched a competition offering $3 million to the entrant or team that built the best algorithm to predict and prevent unnecessary hospitalizations. Kaggle, a start-up profiled earlier by the WSJ, is handling contest logistics.

Axelrod and his fellow Heritage Health Prize entrants are working off of approximately 100,000 Heritage patient records, going back a couple years and scrubbed clean of personal information. From this data entrants must create an algorithm that predicts the number of days a patient will spend in hospital in the next year. The contest started on April 4. It ends on April 3, 2013.

The stakes are huge. The United States spends an estimated $30 billion a year on unnecessary hospitalizations and the contest Web site says that the right model could lead to development of new strategies to reach patients before emergencies occur, reducing unnecessary hospitalizations.

In addition to the $3 million grand prize, the contest rewards six milestone prizes, totaling $230,000, to the entrant with the best prediction algorithm–as based on degree of accuracy–at the time of judging. Today Axelrod, along with teammates David Vogel–the source for Axelrod’s 80/20 profile–and Phil Brierley won the first milestone.

Axelrod has been around the hospital wing long enough to express a bit of skepticism. “From a heath care perspective, changing the process by which you do things is difficult,” he said. “There’s an old saying, culture eats process for lunch every day.”

“Health care attracts a certain kind of individual,” said Dr. Richard Merkin, Heritage Provider Network CEO. “There are so many brilliant people who have allowed us to enter the computer age, Internet age, space travel,” Merkin said. A contest creates an opportunity, he said, for all types of talented individuals to apply their problem solving skills to health care.

The contest has drawn entries from two Nobel Prize winners as well as physicists, computer scientists and mathematicians. One contestant, according to Merkin, has not let a lack of formal education to get in the way of crafting an algorithm based on what he learned from MIT online courses and YouTube videos on machine learning. The contest has over 900 entrants and 6,300 entries.

Many contest entrants just like the challenge.

Willem Mestrom lives in The Netherlands and works in the intelligence department of an online aggregator. After tucking in his two toddlers, he spends 30 minutes to an hour a night on the contest. “Other people watch TV, I do this,” he said.

Last year Mestrom was on a team that placed second in a ratings algorithm contest hosted by Netflix.

His nightly ritual involves math, of course, but also patience–most models are not as effective as one might like –and the common sense to locate patterns and know which patients, owing to hospitals stays or age, are more likely to have another hospital stay.

Today Mestrom’s algorithm took second, behind Axelrod’s team, in the first of six contest milestone awards.

David Vogel, a hedge fund manager, has entered these types of data mining contests before. But he also has a deeper stake. In 1998 his son was born with a congenital heart condition. “It has inspired my interest in medical models and predictive health care,” he said.

Vogel is Axelrod’s teammate, making for a potent combination. “When doctors try to come up with a model, the accuracy is substantially weaker,” Vogel said. On the flip side, Vogel continued, a model created by a mathematician may miss real world interpretation.

“We talk a lot,” said Axelrod, “It’s a lost art.” Dr. Axelrod says that he analyzes Vogel’s models—“I can’t say enough how brilliant David is”—leveraging his medical experience to identify and explain any potential surprises. The partnership between Virginia-based Axelrod, Florida-based Vogel, and Brierley, a data mining expert in Australia, has worked. Winning the first milestone prize was the result of many late night and early morning Skype calls, and online white board sessions.

The team believes that their algorithm could be better if data such as patient drug intake–essential for real-world prediction analysis—was included. Also, according to Vogel, real-world models count on millions of records, not the contest-provided 100,000. But Vogel said that hopefully what they learned “can be applied to bigger, real-world solutions.”

Contest creator Merkin, who established the Richard Merkin Foundation for stem cell research at Harvard as well as other research institutions, sees this contest as the ultimate. “I can’t recall anything that I’ve worked on that has had such a powerful impactful outcome as I expect this to be,” he said.